Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 14807 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke.DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER, BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.

Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all thetrillions and trillions of neuronsthatDIEeach daybecause there areNOeffective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Thursday, May 4, 2017

New deals for drugs: No heart attack or your money back

Warranties and money-back guarantees, long used to entice buyers of
products like hand tools and kitchen gadgets, are now being used to sell
something more crucial: pricey new-generation drugs for diseases like
rheumatoid arthritis and cancer.

Deals being negotiated between drugmakers and the insurers who buy
medicines now sometimes include extra rebates — or even full refunds —
if drugs don't help patients as expected.

It's part of an effort driven by insurers and government health programs
to align the cost of care with the quality of care, and slow the
relentless growth of prescription drug costs.

"We're spending less money on drugs that are less effective," said Dr.
Michael Sherman, chief medical officer for the not-for-profit insurer
Harvard Pilgrim, which has several of these deals and is negotiating
more. Sherman says one-fourth of every dollar it spends on patient care
goes to prescription drugs.

For the patient, it doesn't mean a check in the mail if cancer comes
back after a round of treatment. But it does mean patients could get a
drug that an insurer might otherwise be unwilling to pay for and that
might help them. And insurers, who now can track how patients fare
through electronic medical records, will be reducing wasteful spending
and making at least a dent in overall health care costs.

"It's going to be part of the solution" to soaring drug prices, predicts
Roger Longman, CEO of Real Endpoints, an analytics company that
assesses the value of medicines for drugmakers, insurers and other
clients.

Many new drugs now top $100,000 per year or course of treatment, even
though their benefits are unclear or only marginally better than
cheaper, older drugs. Buyers of those new drugs, usually insurance
companies, are hesitant to pay without assurance the drugs will help
patients. Not only is that bad for patients, it makes insurers spend
even more on complications and hospital stays if the drugs don't work.

As a result, insurers often restrict access to expensive new drugs.
Sometimes that's achieved by making patients pay more out of their own
pockets, or making doctors wade through red tape to get authorization
for a patient's medicine. Sometimes patients have to try cheaper drugs
first, and only when they fail — and the patients' health has
deteriorated — are they allowed to get the pricey new drug.

Pharmaceutical companies have an incentive here, too: These deals may
help them sell more of the new drug they've spent hundreds of millions
of dollars or more developing.

For example, a new generation of injected cholesterol drugs does an
impressive job of reducing so-called bad cholesterol. But the drugs,
Amgen's Repatha and Sanofi's Praluent, cost $14,000 a year, while cheap
generic pills do a good job of lowering cholesterol for most people for
$300 a year or less.

Predictably, insurers often reject prescriptions for these drugs.

So Amgen, trying to boost disappointing sales for a drug expected to be a
huge seller, is offering full refunds to insurers if patients have a
heart attack or stroke while taking its drug. On Tuesday, Amgen
announced its first deal to do so, with Harvard Pilgrim. Sanofi has a
contract with insurer Cigna to pay extra rebates if patient cholesterol
doesn't fall as much as expected.

"It demonstrates the fact that we are standing behind the value the
product has, and we're willing to put some money behind it," said James
Borneman, Sanofi's head of strategic pricing.

Some insurers are now demanding these deals, which are expected to
become standard for some drugs: super-expensive medicines for cancer and
rare diseases, and others that are used widely enough to cost insurers
millions. In addition, the drugs must have a benefit that's easy to
measure, such as keeping kids with asthma out of the emergency room or
preventing growth of cancerous tumors for a certain period.

Cigna has been pursuing more of these types of deals after finding that
some of its earlier efforts "met or exceeded expectations in terms of
benefit to our customers, patients," said Chris Bradbury, who heads
Cigna's prescription benefit program.

One of its early deals, with drugmaker Merck for its diabetes pills
Januvia and Janumet, dates to 2009, with rebates pegged to how much
patients lower blood sugar.

"We keep re-signing that agreement, so I think they're pretty
satisfied," said Bob McMahon, head of U.S. marketing at Merck, which
also has such contracts with insurers and hospital systems covering an
asthma medicine and is negotiating contracts for an infection drug.

Other companies with such deals for one or more medicines include drugmakers Eli Lilly,
Johnson & Johnson, Novartis, Novo Nordisk and Roche's Genentech
unit; insurers Aetna and Priority Health, and prescription benefit
manager Express Scripts.

On their own, these deals are unlikely to reverse the persistent rise in
medical spending, experts say. But they improve the chance that the
money will at least go to treatments that work best — by making sure
insurers and drug companies have something at stake along with the patient.

"There's a risk on both sides with these contracts," said Dr. Mark
Fendrick, director of the University of Michigan's Center for
Value-Based Insurance Design. "Both want to make sure they'll get the
outcome they want."

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Canoeing Moose

Just because my goal is to get back to canoeing and this moose is so ripped and cool looking. And he's even a solo paddler. But his right hand on the T-grip is wrong and the right arm should be extended.